Classifications In Brief: Paprosky Classification of Acetabular Bone Loss

Telleria, Jessica J.M.; Gee, Albert O.

doi:10.1007/s11999-013-3264-4

Cited by 83 publications

(76 citation statements)

References 15 publications

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“…5,6 The cage provides a buttress to the autograft and ensures load sharing across the bone architecture, thus enhancing incorporation. 2,7,8…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography (CT) with 3D reconstruction delineated the bone anatomy highlighting the posterior wall deficiency (Figures 3 to 6). The defect was classified as Type 3A based on the classification proposed by Paprosky et al 7,8 DM THA was planned with reconstruction of the posterior wall and a stainless steel acetabular cage (Evolutis TM ).…”

Section: Case Reportmentioning

confidence: 99%

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Restoring stability in a neglected acetabular fracture with dual mobility total hip arthroplasty: a case report

2019

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<p class="abstract">Neglected acetabular fractures present with varied degrees of soft tissue and bone loss and distorted anatomy resulting in high hip centres. The basic principles of achieving stability and restoring motion are to augment the acetabular bone loss, prevent protrusio in the long term and use a prosthesis that prevents dislocation. We report a case of a 22 year old neglected acetabular fracture managed successfully with a femoral head autograft, anti protrusio cage and dual mobility total hip arthroplasty.</p>

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“…5,6 The cage provides a buttress to the autograft and ensures load sharing across the bone architecture, thus enhancing incorporation. 2,7,8…”

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Restoring stability in a neglected acetabular fracture with dual mobility total hip arthroplasty: a case report

2019

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“…Inclusion criteria were patients that had plain X-rays, standard multiplanar CT scan and 3D CT reconstructions representing each Paprosky type defect available for review. Bone defects were classified independently by two fellowship-trained adult reconstruction surgeons (one type 1 defect, one type 2A, two type 2B, two type 2C, one type 3A, and one type 3B acetabular defects) based on the Paprosky classification of acetabular bone loss ( Table 1 ) 1 8) . X-rays, CT scan and 3D CT reconstructions were classified based on several anatomic landmarks described in the classification system.…”

Section: Methodsmentioning

confidence: 99%

Utility of Radiographs, Computed Tomography, and Three Dimensional Computed Tomography Pelvis Reconstruction for Identification of Acetabular Defects in Residency Training

et al. 2017

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PurposeThe Paprosky classification system of acetabular defects is complex and its reliability has been questioned. The purpose of this study was to evaluate the effectiveness of different radiologic imaging modalities in classifying acetabular defects in revision total hip arthroplasty (THA) and their value of at different levels of training.Materials and MethodsBone defects in 8 revision THAs were classified by 2 fellowship-trained adult reconstruction surgeons. A timed presentation with representative images for each case (X-ray, two-dimensional computed tomography [CT] and three-dimensional [3D] reconstructions) was shown to 35 residents from the first postgraduate year of training year of training (PGY-1 to PGY-5), 2 adult reconstruction fellows and 2 attending orthopaedic surgeons. The Paprosky classification of bone defects was recorded. The influence of image modality and level of training on classification were analyzed using chi-square analysis (alpha=0.05).ResultsOverall correct classification was 30%. The level of training had no influence on correct classification (P=0.531). Using X-ray led to 37% correctly identified defects, CT scans to 33% and 3D reconstructions to 20% of correct answers (P<0.001). There was no difference in correct classification based defect type (P<0.001). Regardless of level of training or imaging, 64% of observers recognized type 1 defects, compared to only 16% correct recognition of type 3B defects.ConclusionUsing plain X-rays led to an increased number of correct classification, while regular CT scan and 3D CT reconstructions did not improve accuracy. The classification system of acetabular defects can be used for treatment decisions; however, advanced imaging may not improve its utilization.

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“…Acetabular deficiencies were classified intraoperatively, using the American Academy of Orthopaedic Surgeons Acetabular Deficiency Classification, as type IIIb (combined deficiency of the rim, the medial wall and the dome) 10. The defect of the left medial wall was between 35 and 45 mm and the right medial wall between 20 and 30 mm (figure 2).…”

Section: Treatmentmentioning

confidence: 99%

Delayed presentation of bilateral central hip protrusio acetabuli: evidence-based management

Drakou¹,

Lex

Psifis

et al. 2018

BMJ Case Reports

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This is a case of a previously healthy 51-year-old man who sustained bilateral central hip dislocations following a sudden presentation of epileptic seizures. The patient was initially treated conservatively for a period of 9 months. On presentation, he had gross disability due to stiffness in both hips and left peroneal nerve paresis. Through minimally invasive direct anterior approaches, bilateral total hip arthroplasties were performed using tripolar head articulations. These were cemented into a biologic acetabular buttress constructed out of autologous bone graft. The femoral heads and necks were used as plugs and pressed into the acetabular defects, putting the medial acetabular walls under tension. At 24 months' follow-up, there was a good clinical outcome, and the acetabular walls remodelled bilaterally. In conclusion, in traumatic protrusio acetabuli, a functional, biologic reconstruction of the acetabular wall can be facilitated with the application of distraction osteogenesis (tension-stress) principles while using minimally invasive surgical techniques.

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Classifications In Brief: Paprosky Classification of Acetabular Bone Loss

Cited by 83 publications

References 15 publications

Restoring stability in a neglected acetabular fracture with dual mobility total hip arthroplasty: a case report

Restoring stability in a neglected acetabular fracture with dual mobility total hip arthroplasty: a case report

Utility of Radiographs, Computed Tomography, and Three Dimensional Computed Tomography Pelvis Reconstruction for Identification of Acetabular Defects in Residency Training

Delayed presentation of bilateral central hip protrusio acetabuli: evidence-based management

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